Provider Demographics
NPI:1427682947
Name:SMITH, LEWIS EVERETT (LPC)
Entity type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:EVERETT
Last Name:SMITH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 DARTFORD LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3234
Mailing Address - Country:US
Mailing Address - Phone:301-357-2862
Mailing Address - Fax:
Practice Address - Street 1:1130 VARNEY ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4372
Practice Address - Country:US
Practice Address - Phone:202-450-5822
Practice Address - Fax:202-918-9698
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional